Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02269 | Date 01/12/2018 |
| Token No | SM/18-19/4509 01/12/2018 | Serial | 036 Last Visit: 01/12/2018 |
| Patient Name | Mr. SK MUJAFFAR | Contact No | |
| Address | 7, CHATRA ARBINDA SARANI | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||